Brunswick Area Historical Society

MEMBERSHIP FORM

Return to: Brunswick Area Historical Society

4613 Laurel Road, P.O. Box 714

Brunswick, OH 44212

Name: _____________________________________________

Address: ____________________________________________

City, State, Zip: ______________________________________

Telephone: __________________________________________

Email address: _______________________________________

Membership Fees: $ 10.00 Over 65 or Student

15.00 Individual under 65

20.00 Family

Patron: $ 25.00 Silver

50.00 Golden

75.00 Platinum
100.00 and over Diamond

           Corporate:                          $   100.00

Questions, suggestions, donations – please call (330)273-8000 X 4

Email address:  brunswickareahistory@gmail.com

Website: www.brunswickhistory.com